The standing committee on health for the 12 th five year Plan has proposed adding 18,000 additional undergraduate medical seats, and nearly 11,000 post-graduate seats between 2012 and 2017.
In its report to the Union health ministry, exclusively available with TOI, the panel has recommended for the increase of undergraduate medical seats from 41,569 to 66,000 and PG seats from 20,868 to 31,000. It has proposed setting up of 30 new medical colleges with public financing in states that need them the most. It has recommended setting up of 132 Auxiliary Nursing Midwifery (ANM) and 137 General Nursing Midwifery (GNM) schools through public financing with a focus on under-serviced areas and starting paramedical education courses in 149 government medical colleges and paramedical institutions in 26 states.
Trained and competent human resource, the committee says, is the foundation of an effective healthcare system. India produces 30,000 doctors, 18,000 specialists, 30,000 AYUSH doctors, 54,000 nurses, 15,000 ANMs and 36,000 pharmacists annually. “Yet, geographic and rural-urban imbalance exists in training and availability of human resource. Medical colleges are unevenly spread across the states with wide disparities in the quality of education. Only 193 districts of the total of 640 districts have a medical college – the remaining 447 districts do not have any medical colleges,” the report says. Against a World Health Organization recommended norm of 23/25 health workers (doctors, nurses, midwives) per 10,000 population, India has 19 health workers per 10,000 (doctors-6, nurses and midwives-13).
Besides, there are 7.9 lakh registered AYUSH practitioners (6.5 per 10,000). The urban density of doctors and nurses is four and three times, respectively, as compared to rural areas. “Such a skewed distribution results in large gaps in demand and availability, particularly for governmental health care facilities. The 12 th Plan aims to expand facilities for medical, nursing and paramedical education, creating new skilled health worker categories, enable AYUSH graduates to provide essential healthcare by upgrading their skills through bridge courses, establish a human resource health management system for improved recruitment, retention and performance; put in place an incentive structures, create career tracks for competence-based professional advancement and create a independent and professional regulatory environment,” the report adds.
The committee has proposed that AYUSH doctors can be trained through short bridge courses to manage essential healthcare at primary care settings. Medical officers deployed in primary and secondary health facilities need to be multi-skilled so that the can manage “day to day conditions relating to obstetrics, anesthesia, psychiatry, pediatrics including neonatology, trauma care.” The ministry has been told to orient medical education to needs of the society, starting with examining the curriculum of medical education so as to equip graduates to independently function as general practitioners, possess hands-on skills, and be sensitive to issues like social determinants of health, equity, essential medicines and generics.
Source : Times of India